Go Retire Psychiatrist

I just had a few comments to share related Dr. George Dawson’s post I highlighted yesterday. This whole discussion about deprescribing is complicated and naturally leads to further thought about how to approach the complicated clinical relationship issues involved.

There was a relevant article in Psychiatric Times which addressed some of the factors involved in navigating the process of what should be the challenges in taking good care of persons suffering from psychiatric disorders which require medical management as well as psychotherapy.

One of the ways to stay on top of how patients are responding (or not) to medications is measurement-based care. This involves having patients complete self-report questionnaires about their problems. This can be a basis for shared clinical decision-making regarding changes in the treatment plan.

I was in private practice very briefly many years ago and the time constraints in busy psychiatry clinics can weigh against using measurement-based care in private practice. For example, I used the Clinically Useful Depression Outcome Scale, Self-Report (CUDOS-SR) and the Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR). They were pretty time-consuming, unfortunately.

Dr. Mark Zimmerman is a psychiatrist at Brown University in Rhode Island (although he started his career at The University of Iowa as a research assistant) who designed the CUDOS-SR and used it in an online program years ago although I can’t find it anymore. He wrote many articles about the rating scale.

And then, I ran across a website, MindMetrix, with which I’m not familiar. The article is entitled “Measurement-Based Care in Psychiatry.” The company has an obvious sales pitch tone, which is to be expected. On the other hand, it takes advantage of the ubiquity of electronic devices which many people have nowadays. It’s a subscription service model. It’s not cheap, but clinicians can try it for free.

I don’t know how long MindMetrix has been in business. If anyone knows about how this model works and about any competitors, please drop comments.